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General NPI Number Information
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NPI Number | 1437742798
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Entity Type | Individual
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Provider Name | OLIVIER MBA CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 3869 BRENTVIEW PL NW
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City | KENNESAW
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State | GA
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Zip | 30144-2292
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Country | US
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Telephone | 678-333-1944
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Fax |
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Provider Business Mailing Address
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Address Line | 7974 UW HEALTH CT
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City | MIDDLETON
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State | WI
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Zip | 53562-5531
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN195909
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License Number State | GA
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